The Quagmire
How American medicine is destroying itself.
Daniel Callahan and Sherwin B. Nuland
TNR May 19, 2011
In 1959, the great biologist René Dubos wrote a book called Mirage of Health, in which he pointed out that “complete and lasting freedom from disease is but a dream remembered from imaginings of a Garden of Eden.” But, in the intervening decades, his admonition has largely been ignored by both doctors and society as a whole. For nearly a century, but especially since the end of World War II, the medical profession has been waging an unrelenting war against disease—most notably cancer, heart disease, and stroke. The ongoing campaign has led to a steady and rarely questioned increase in the disease-research budget of the National Institutes of Health (NIH). It has also led to a sea change in the way Americans think about medicine in their own lives: We now view all diseases as things to be conquered. Underlying these changes have been several assumptions: that medical advances are essentially unlimited; that none of the major lethal diseases is in theory incurable; and that progress is economically affordable if well managed.
But what if all this turns out not to be true? What if there are no imminent, much less foreseeable cures to some of the most common and most lethal diseases? What if, in individual cases, not all diseases should be fought? What if we are refusing to confront the painful likelihood that our biological nature is not nearly as resilient or open to endless improvement as we have long believed?
(More here.)
Daniel Callahan and Sherwin B. Nuland
TNR May 19, 2011
In 1959, the great biologist René Dubos wrote a book called Mirage of Health, in which he pointed out that “complete and lasting freedom from disease is but a dream remembered from imaginings of a Garden of Eden.” But, in the intervening decades, his admonition has largely been ignored by both doctors and society as a whole. For nearly a century, but especially since the end of World War II, the medical profession has been waging an unrelenting war against disease—most notably cancer, heart disease, and stroke. The ongoing campaign has led to a steady and rarely questioned increase in the disease-research budget of the National Institutes of Health (NIH). It has also led to a sea change in the way Americans think about medicine in their own lives: We now view all diseases as things to be conquered. Underlying these changes have been several assumptions: that medical advances are essentially unlimited; that none of the major lethal diseases is in theory incurable; and that progress is economically affordable if well managed.
But what if all this turns out not to be true? What if there are no imminent, much less foreseeable cures to some of the most common and most lethal diseases? What if, in individual cases, not all diseases should be fought? What if we are refusing to confront the painful likelihood that our biological nature is not nearly as resilient or open to endless improvement as we have long believed?
(More here.)
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